High Level Of Confidence Research Articles

Flow-cytometry as an auxiliary in the diagnosis of primary humoral immunodeficiencies.

Antibody deficiencies encompass a wide spectrum of pathologies and constitute approximately 50 % of primary immunodeficiencies; with cytometry, it is possible to evaluate the immune status rapidly, effectively and at low cost. To assess, by means of flow cytometry, the cells of patients with three types of primary humoral immunodeficiencies. Using flow cytometry, blood samples from patients and healthy subjects were analyzed with different monoclonal antibodies. Using various stains, a severe decrease in B lymphocytes was shown in patients with X-linked agammaglobulinemia, as well as a lack of CD154 expression in patients with hyper-immunoglobulin M syndrome, and heterogeneity of B lymphocyte subpopulations in patients with common variable immunodeficiency. Flow cytometry enables early diagnosis of primary immunodeficiencies with a high level of confidence and, in many cases, identification of the genes involved.

The effectiveness of psychological interventions for borderline personality disorder for those who misuse substances: a systematic review and narrative synthesis

Purpose This study aims to identify and critically appraise literature exploring the effectiveness of psychological interventions in improving borderline personality disorder (BPD) symptomatology for individuals who misuse substances. Design/methodology/approach Systematic searches across six databases (PsycINFO, Embase, Scopus, Medline, CINAHL and ProQuest), hand searching and citation chaining were conducted between June and August 2021. Key search terms included BPD, substance use, therapy and effect. Study and sample characteristics, interventions, outcome measures and key findings were extracted. Quality assessment and a narrative synthesis approach were used to explore strengths, limitations and relationships between and within studies. Findings Seven eligible reports were included and showed mostly adequate quality. Mixed samples, designs, outcomes, definitions and implementation varied. Treatment completion did not differ significantly between those who did and did not misuse substances. Interventions demonstrated effectiveness in relation to psychiatric symptoms, hospital admissions, self-efficacy and impulsive and self-mutilating (cutting, burning, etc.) behaviours. No effects were found for suicidal or parasuicidal (threats, preparation and attempts) behaviours. Research limitations/implications This review only considers individuals with diagnoses of BPD who are not accessing substance misuse treatment. Radically open dialectical behaviour therapy (DBT), therapeutic communities and other interventions are available as interventions for substance misuse (Beaulieu et al., 2021). Based on the findings of this review, it should not be assumed that such interventions affect substance misuse rather than BPD symptomatology. Therefore, future research might explore the effectiveness of these interventions on BPD symptomatology despite this not being the primary target for intervention. Practical implications Despite McCrone et al. (2008) noting the cost of this population’s difficulties to both themselves and services, the limited number of studies in this area is astonishing. Despite a lack of quality in the data available, there i some evidence to support the use of DBT and general psychiatric management (GPM) interventions for those with BPD and concurrent substance misuse. It is therefore of principal importance that health and social care services action Public Health England’s (2017) recommendations. Individuals with coexisting BPD and substance misuse would then receive support from any professional they see, who could then refer for psychological therapies. Originality/value Although the reports appear to show that DBT, integrated therapies and GPM may be effective for this population, conclusions cannot be drawn with high levels of confidence due to heterogeneity among studies. The findings indicate that future, high-quality research is needed to test the effects of interventions on BPD symptomatology for those who misuse substances. Randomised controlled trials with sufficient statistical power, homogeneous outcomes and standardised methodological approaches are needed.

Summarising multiple bounds of the average causal effect in Mendelian randomisation.

Summarising multiple bounds of the average causal effect in Mendelian randomisation.

Students' Motivation in an EFL Reading Class

Students' motivation in EFL reading classes is typically low, but little research on students' motivation in EFL reading instruction has been done in Vietnam. There is an open-ended question to solicit the students' suggestions on how to increase their motivation and involvement in learning reading. This research is a case study examining the students' motivation for learning reading in an English-major class (n=34). The tool was adapted from Dörnyei's (2005, 2009) questionnaire of the L2 motivational self system, including ideal L2 self, ought-to L2 self, instrumentality-promotion and instrumentality-prevention, their attitudes, self-confidence, and intended effort toward learning reading. The findings revealed that the ideal L2 self was identified as the highest motivation, followed by instrumentality-promotion and instrumentality-prevention. Most of the students expressed positive attitudes and relatively high levels of confidence and effort in their learning reading. Finally, the paper offers several recommendations for boosting students' motivation and engagement in reading instructions.

Application of Delphi method to identify sustainable university assessment criteria for Vietnam

Abstract: This study was conducted to determine the criteria for evaluating sustainable universities for Vietnam. The Delphi method is used to collect opinions of experts from the field of environment and sustainable development on some proposed criteria. The results of the first round of Delphi were synthesized and analyzed according to KAMET principles. A set of proposed criteria have been identified and selected. The Kendall coefficient, calculated from the Delphi round 2 questionnaire, is 0.52, showing a strong consensus and high level of confidence of experts on the four groups of sustainable university evaluation criteria for Vietnam, including: Research training and participation in extracurricular activities; Operation; Governance and policy; Community involvement and social responsibility. The research results provide the foundation for a set of criteria to evaluate sustainable universities for Vietnam.

Investigation of several halogenated organic compounds reacting with O2+• using selective reagent ion-time-of-flight-mass spectrometry

Halogenated organic compounds represent an important group of chemicals that have found use in a wide array of research, medical and industrial applications. This raises the question as to which analytical techniques are most suitable for detecting and monitoring in real-time these compounds in the environment. To provide underpinning information on the potential use of chemical ionisation mass spectrometric techniques, we present here details of a selective reagent ion-time-of-flight-mass spectrometry (SRI-ToF-MS) fundamental study characterising the reactions of O2+• with six common halogenated organic compounds, namely, 2,2,2-trifluoroethanol (TFE, CF3CH2OH), 1,1,1,-trifluoroacetone (TFA, CH3COCF3), 1,1,2,2-tetrafluoro-3-methoxypropane (TMP, CHF2CF2CH2OCH3), 1,1,1,3,3,3-hexafluoro-2-methoxypropane (isoflurothyl, (CF3)2–CHO–CH3)), 2-chloro-1,1,2-trifluoro-1-methoxyethane (CTME, CH3OCF2CHFCl) and 1-ethoxy-1,1,2,2-tetrafluoroethane (ETE, CH3CH2OCF2CHF2). We investigated the distributions of the product ions as a function of the reduced electric field strength (E/N) between 65 Td and 205 Td. Five of the halogenated organic compounds generated rather simple product ion distributions. Only one, non-halogenated product ion resulted from each of the reactions of O2+• with TFE (CH2OH+), TFA (CH3CO+) and TMP (CH3OCH2+). For the other two out of the first five compounds, isoflurothyl and CTME, three product ions were observed, but only one of these was dominant with a product ion branching percentage of ∼80% throughout the reduced electric field range investigated: C3H4F3O+ resulting from isoflurothyl and C2H3F2O+ from CTME. The sixth compound, ETE, displayed a much richer reaction ion chemistry than the other five compounds. A total of eight product ions were identified, two of which dominated over most of the investigated E/N range, namely C4H5F4O+ and C2H5+. The potential chemical pathways that lead to the formation of the major and minor observed product ions are discussed for all six compounds. We show that SRI-ToF-MS is a useful technique to study the reactions of halogenated organic compounds with O2+•. Its potential use for monitoring TFE, TFA and TMP is limited because the single product ion observed for each of these volatiles is not sufficiently specific and thus characteristic to the originating compound (i.e., reactions of O2+• with non-halogenated organic compounds will also result in the same product ions). However, SRI-ToF-MS could be considered as a potential analytical tool to detect and monitor isoflurothyl, CTME and ETE, as the fluorinated product ions resulting from their reactions with O2+• allow for their detection with a high level of analytical confidence.

Factors That Influence Orthopedic Women Residents’ Selection of Adult Reconstruction

BackgroundStereotypes may discourage women from going into the historically male-dominated field of Adult Reconstruction. Other factors such as interest, confidence, and a sense of belonging may influence subspecialty choice. The objective of this study was to survey orthopedic surgery residents regarding their perceptions about Adult Reconstruction. MethodsA validated survey evaluating social determinants of behavior was adapted to assess orthopedic surgery residents’ perceptions of Adult Reconstruction. The survey was electronically distributed to residents from 16 United States and Canadian Accreditation Council for Graduate Medical Education–accredited residency programs. There were 93 respondents including 39 women (42%) and 54 men (58%). Study data were collected and managed using an electronic data capture tool. Descriptive statistics were reported for all continuous variables. Percentiles and sample sizes were reported for categorical variables. ResultsWomen and men reported similar interest in Adult Reconstruction (46% versus 41%, P = .60). Fewer women reported that they were encouraged to go into Adult Reconstruction by faculty (62% versus 85%, P = .001). Women and men reported similar confidence in their own ability to succeed in the subspecialty of Adult Reconstruction. However, when asked about the ability of other residents, both sexes rated men as having higher levels of confidence. Women and men perceived other residents and faculty felt “men are better Adult Reconstruction surgeons,” but did not personally agree with this statement. ConclusionWomen and men residents expressed similar rates of interest and self-confidence in Adult Reconstruction, but there were social barriers including negative stereotypes that may prevent them from pursuing careers in Adult Reconstruction.

Impact of anxiety and confidence in virtual reality‐mediated learning transferred to hands‐on tasks

AbstractBackgroundBenefited from advances in technology, virtual reality (VR) has been widely applied to learning content in operational training as well as hands‐on courses. However, most current studies tend to evaluate learning effectiveness in this application, and few were focused on how learners can be benefited from transferring the knowledge learned to real‐world field performance. Moreover, in application‐oriented hands‐on courses such as embedded electronic circuits, to our best knowledge, none were presented in interactive learning materials with the combination of VR and neither were the understanding of the changes in cognition, learning anxiety, and learning confidence during the learning process.Method and ObjectiveWe combine VR technology with hands‐on tasks to design a VR‐based embedded electronic circuit learning system. We conduct a quasi‐experiment to investigate differences in knowledge, comprehension, and application levels in different learning environments, and to assess learning performance, learning anxiety, and learning confidence levels when applying the knowledge learned to real‐world hands‐on tasks.ResultsGroups that receive VR‐mediated training exhibit superior knowledge, comprehension, and application levels. In addition, learners with higher levels of knowledge and application exhibit lower learning anxiety and higher learning confidence during practical application tasks.ConclusionsWe investigate the learning outcomes of learners on practical hands‐on tasks after VR‐mediated learning. To improve the learning experience and performance for learners in an embedded electronic circuit course, we discuss the learning performance in terms of the knowledge and concepts learned in the VR environment and transferred to the real world. The results show that learners achieve better cognitive levels in the learning process through the VR system described here. Better performance on hands‐on tasks was also obtained as well as low anxiety and high confidence levels.

Entropic spatial auto-correlation of voter uncertainty and voter transitions in parliamentary elections

This paper studies a novel spatial auto-correlation model of voter uncertainty across districts. We use the Moran I index to measure the auto-correlation of Shannon, relative Shannon, Tsallis and relative Tsallis entropies of regional electoral outcomes with respect to geographic adjacency, proximity and sectarian adjacency. Using data from the Lebanese parliamentary elections, we find strong geographic and gravitational adjacency correlations. More importantly, there is a notably strong correlation in sectarian adjacency in both 2018 and 2022 elections, with a very high level of confidence. This result asserts the dominance of the sectarian factor in Lebanese politics. We also introduce the method of maximized general entropy estimation that allows us to determine the Markov transition matrix of voters between consecutive elections.

Competence Development Strategies after COVID-19: Using PBL in Translation Courses

The 2019 pandemic had a direct impact on all educational stakeholders. While many teachers and trainers regarded the changes with some scepticism, others embraced the opportunity to integrate technology into their teaching-and-learning methods and resources. As translation trainers, it is essential to follow and understand the translation market. Translators require vast competencies, amongst which is the flexibility to adapt. In translation training, project-based learning (PBL) has been established as an essential teaching-and-learning method, as it has proven to foster the development of essential competencies, since it simulates the translator’s work environment. Thus, the need to implement new strategies within a short timeframe reinforced the practice of PBL. PBL reflects the work of a freelance translator, because it places the student at the centre of the learning process. In these situations, student self-regulation becomes essential, as it is necessary to analyse the market/situation/project received and be flexible enough to adapt to the specific context. As of 2018–2019, ISCAP implemented PBL as the main teaching-and-learning method in its Technical Translation courses. At the same time, on these courses, an ongoing qualitative quasi-experimental study on student self-regulated learning (SRL) began. The purpose is to understand student perception of their self-regulation competence and its development, or lack thereof, after using PBL to complete translation assignments. The study presented in this article aims to examine the possible effects an online-PBL approach may have on a student’s SRL during the pandemic. Students enrolled in the translation courses voluntarily answered a survey on SRL two times: at the beginning and then at the end of the course. The purpose was to analyse and compare each student’s responses before and after using PBL strategies, identifying changes in student perception over a six-month period. Additionally, we compare each group’s results over a period of three years, which includes the lockdown. Statistical analysis showed that a higher level of self confidence in autonomous learning was achieved, but a lower level of belief in the importance and usefulness of the course contents was noted. Additionally, the study revealed that, with the exception of time-management, student SRL increased. Results indicate that PBL is a useful simulation of the translation labour market and that it does enhance essential competencies, amongst which is student SRL.

Assessment of Confidence in Communication Skills and Its Practice With Patients Among Medical Professionals in Trichy, India.

Introduction One of the most fundamental aspects of medicine is the doctor-patient relationship. Many factors influenced this link, including socio-cultural patterns, economic levels, political systems, and health systems. In India, there is an increase in violence toward physicians. Almost every now and then, the newspaper comes with headlines about a doctor being abused by patients or their families. Concerns regarding the absence of good doctor-patient communication among Indian doctors prompted an assessment of the current situation. The major purpose of this study is to assess the confidence of tertiary care hospital interns and post-graduates in their communication skills. Materials and methods In May and June 2021, a cross-sectional survey was conducted among all interns and post-graduates from various departments at a tertiary care hospital and research center in Trichy, Tamil Nadu, India. The questions were designed to measure the confidence of physicians' communication with patients. The Likert scale was used to rate the "confidence in using" and "actual use" of communication skills with patients, which constitute two sections in our questionnaire. Google forms were used to collect data. The information was then exported to a Microsoft Excel spreadsheet. SPSS software version 22.0 was used to analyze the data. Results For confidence in their communication skills, the participants obtained a mean score of 2.98 (S.D. = 0.44). Participants obtained an average score of 2.28 (S.D. = 0.89) for practicing confident communication with patients. It was found that persons who had higher confidence levels had a negative correlation (ρ = -0.318) with that during their communication with patients and this was statistically significant (p-value = < 0.001) Conclusion Despite having confident communication skills, medical practitioners in India hardly ever practice them with their patients. This gap must be explored by conducting qualitative studies to address effective communication skills among health professionals.

Motivation inspiring confidence: effect of scenario-based learning on self-confidence among prelicensure nursing students

Clinical training is the heart and soul of nursing education. Practicing nursing skills in a structured nonthreatening interactive environment affords a motivating learning experience. Scenario-Based learning (SBL) is an innovative pedagogical approach where authentic scenarios are used to support active learning strategies such as problem-based, case-based learning, role-play, and simulation. The current study aims to determine the effect of scenario-based practical training (SBPT) on nursing students’ self-confidence regarding nursing care of preterm neonates. A quasi-experimental, two-group, pre- post-test study was carried out in the neonatal intensive care unit (NICU) at University Specialized Hospital in Smouha, Alexandria. A sample of 60 senior nursing students received a didactic lecture and engaged in an interactive SBPT session regarding the care of preterm neonates and the common problems that affect them on a medium-fidelity manikin. The scenario included cues, skills, triggers, and a preordained series of actions with timing for the task to be completed. Reflection on students’ performance was done through debriefing sessions using the plus-delta model. The study results revealed that all of the nursing students in the study group exhibited high levels of confidence after SBPT compared to only 10% of those in the control group (P < 0.001). It can be concluded that the application of a motivational and interactive teaching approach as SBPT was effective in enhancing nursing students’ self-confidence in assessing, and caring for preterm neonates with familiar and complicated medical diagnoses as well as solving the common problems affecting these vulnerable age-groups.

Assessment of exposure to pesticide mixtures in five European countries by a harmonized urinary suspect screening approach.

Humans are exposed to a mixture of pesticides through diet as well as through the environment. We conducted a suspect-screening based study to describe the probability of (concomitant) exposure to a set of pesticide profiles in five European countries (Latvia, Hungary, Czech Republic, Spain and the Netherlands). We explored whether living in an agricultural area (compared to living in a peri-urban area), being a a child (compared to being an adult), and the season in which the urine sample was collected had an impact on the probability of detection of pesticides (-metabolites). In total 2088 urine samples were collected from 1050 participants (525 parent-child pairs) and analyzed through harmonized suspect screening by five different laboratories. Fourty pesticide biomarkers (either pesticide metabolites or the parent pesticides as such) relating to 29 pesticides were identified at high levels of confidence in samples across all study sites. Most frequently detected were biomarkers related to the parent pesticides acetamiprid and chlorpropham. Other biomarkers with high detection rates in at least four countries related to the parent pesticides boscalid, fludioxonil, pirimiphos-methyl, pyrimethanil, clothianidin, fluazifop and propamocarb. In 84% of the samples at least two different pesticides were detected. The median number of detected pesticides in the urine samples was 3, and the maximum was 13 pesticides detected in a single sample. The most frequently co-occurring substances were acetamiprid with chlorpropham (in 62 urine samples), and acetamiprid with tebuconazole (30 samples). Some variation in the probability of detection of pesticides (-metabolites) was observed with living in an agricultural area or season of urine sampling, though no consistent patterns were observed. We did observe differences in the probability of detection of a pesticide (metabolite) among children compared to adults, suggesting a different exposure and/or elimination patterns between adults and children. This survey demonstrates the feasibility of conducting a harmonized pan-European sample collection, combined with suspect screening to provide insight in the presence of exposure to pesticide mixtures in the European population, including agricultural areas. Future improvements could come from improved (harmonized) quantification of pesticide levels.

Abstract P2-03-02: Prospective assessment of the decision-making impact of the Breast Cancer Index in the BCI Registry Study

Abstract Background: The Breast Cancer Index (BCI) is a validated gene expression assay that provides a quantitative individualized risk of late recurrence and predicts the likelihood of benefit from extended endocrine therapy (EET) in HR+ early-stage breast cancer. The objective of this analysis was to assess the impact of BCI on clinical decision-making regarding EET in the BCI Registry Study. Methods: The BCI Registry Study is an ongoing, prospective, large-scale study to investigate the long-term clinical outcome, decision impact, and medication adherence in HR+ early-stage breast cancer patients receiving BCI testing as part of routine clinical care. Per protocol, physicians and patients completed pre- and post-BCI test questionnaires to assess the following: physician decision-making regarding EET; physician confidence with decision-making; patient preferences for EET; patient concerns about the cost, side effects, drug safety and benefit of EET; and patient satisfaction regarding treatment recommendation. Pre- and post-BCI responses were compared using McNemar’s test and Wilcoxon signed rank test. Results: Pre- and post-BCI test physician and patient questionnaires were completed for 843 and 823 patients, respectively. For the patients included in this analysis, mean age at enrollment was 65y and 88.4% of patients were postmenopausal. 74.7% of tumors were T1, 53.4% were G2, 75.3% N0, and 13.8% HER2-positive. Following BCI testing, physicians changed treatment recommendations for EET in 40.1% (338/843) of patients (p&amp;lt; 0.0001). In cases in which physicians recommended EET prior to BCI testing, 44.7% (214/479) changed their recommendation not to extend endocrine therapy. Of these cases, 98.1% (210/214) were BCI Prognostic low risk and/or BCI (H/I) Predictive low likelihood of benefit from EET. In cases in which physicians did not recommend EET prior to BCI testing, 34.6% (124/358) changed their recommendation in favor of EET. In such cases, 87.1% (108/124) of cases were BCI Prognostic high risk and/or BCI (H/I) Predictive high likelihood of benefit from EET. Further, following BCI testing, 38.8% (327/843) of physicians felt more confident in their recommendation (p&amp;lt; 0.0001). The percentage of physicians having high confidence levels (confident or strongly confident) increased from 58.1% (490/843) before BCI testing to 80.5% (679/843) after BCI testing. The percentage of physicians having low confidence levels (not at all confident, not confident, or ambivalent) decreased from 39.1% (330/843) before BCI testing to 18.7% (158/843) after BCI testing. In addition, 40.5% (341/843) of patients felt more comfortable with their EET decision (p&amp;lt; 0.0001) following BCI testing. Notably, changes in patient preferences for EET correlated with BCI test results. In BCI (H/I)-Low patients, 46.9% (241/514) showed a decreased preference for EET (p&amp;lt; 0.0001) while in BCI (H/I)-High patients, 28.2% (87/309) showed an increased preference for EET (p&amp;lt; 0.0001). Compared with baseline, after BCI testing, significantly more patients were less concerned about cost (20.9%, p&amp;lt; 0.0001), drug safety (25.4%, p=0.0014), and the benefits of EET (29.3%, p=0.0002). No significant change in concern regarding side-effects was observed (p=0.1486). Conclusions: This first analysis in a large patient cohort of the BCI Registry confirms previous findings on the significant clinical decision-making impact of BCI for extending adjuvant endocrine therapy. Incorporating BCI into clinical practice resulted in changes in physician recommendations for EET in over 40% of cases, while at the same time increasing physician confidence in their recommendations. Knowledge of the BCI result also improved patient satisfaction and reduced patient concerns regarding cost, drug safety and benefit of EET. Citation Format: Tara B. Sanft, Jenna Wong, Brandon O’Neal, Natalia Siuliukina, Rachel C. Jankowitz, Mark Pegram, Jenny Fox, Yi Zhang, Kai Treuner, Joyce O’Shaughnessy. Prospective assessment of the decision-making impact of the Breast Cancer Index in the BCI Registry Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-03-02.

The efficiency of statistical and artificial neural network techniques on evaluating and predicting compressive strength of sustainable SCC with basalt fibers

This work presents the power of employing statistical and Artificial Intelligence (AI) approaches in analyzing and predicting the effect of basalt fibers on the mechanical behavior of high-strength sustainable self-consolidating concrete (SCC). To alleviate the greenhouse gas emission from the Portland cement manufacturing process, an experimental program with a concrete mix design of up to 80% of the cement content is replaced with a combination of different supplementary materials. The used cementitious materials (i.e., ground granulated blast furnace slag (GGBS), fly ash (FA), and silica fume (SF)) were employed in the design mix as binary, ternary, and quaternary blends with different proportions of cement replacement. Additionally, basalt fibers were integrated into the concrete mixtures with three dosages from the total cementitious materials weight, i.e., 0.5%, 0.75%, and 1.00%. The aim of introducing those fibers was to investigate their ability in enhancing or regaining the mechanical strength compromised with cement replacement. As the compressive strength results showed some ambiguous trends with basalt fiber mixes, analysis of variance (ANOVA) was used to determine the controlling parameter on the compressive strength behavior. The analysis elucidated that the highest contributor to the strength was cement with 58%, followed by the GGBS with 21%, while the remaining factors were 12%, 6%, and 3% for FA, SF, and basalt fibers, respectively. Further, all the experimental data were utilized in an Artificial Neural Networks (ANN) tool to predict the compressive strength of the developed SCC mixes. For maximum prediction accuracy, different network configurations for one-hidden and two-hidden layers networks were exploited. Results demonstrated that high prediction accuracy was attained through 6-28-1 and 6-25-20-1 networks with a high confidence level limited to a ±10% error margin. It was concluded that statistical, and ANN techniques to analyze, capture, and predict the effect of different additives on the concrete compressive strength are efficient despite having ambiguous behavior with the experimental results.

National qualifications in Scotland: A lightning rod for public concern about equity during the pandemic

AbstractScotland, traditionally, has high levels of confidence in teachers. Fairness and justice are key concepts in policy and practice in Scottish education. For more than 100 years, the high‐stakes assessment system in Scotland, with the Scottish Higher qualification at its heart, has been crucial to that sense of opportunity and justice. However, in 2019–2020, public confidence in high‐stakes assessment in Scotland, as in other United Kingdom countries, was dented. In Scotland, the Covid‐19 pandemic meant that schools were closed, teachers provided online learning opportunities for pupils working at home and, for the first time in 130 years, it was not possible to run national examinations. To ensure that learners were not further disadvantaged, alternative approaches to gathering evidence for qualifications were instigated. However, these results were challenged as socially unjust and the results that had been nationally moderated were replaced by results based on locally moderated teachers' professional judgement. As Scotland looks to qualifications beyond Covid‐19, trust must be re‐built. This article reports on a participative research project that sought to understand public perceptions of standards and fairness across a range of key communities following this experience. Drawing on both qualitative and quantitative data, we analyse factors which affected trust in National Qualifications under the pandemic. The evidence suggests that when considering what matters for qualifications to be trusted, technocratic solutions are likely to be rejected by stakeholders. Understanding and responding to what led to the mistrust of qualifications in Scotland will be crucial to inform its future qualifications system.

Medical emergencies in dental practice: A nationwide web-based survey of Italian dentists

ObjectiveDentists must be prepared to manage medical emergencies, which are arisen during dental practice together with the increase of age population and medically compromised patients. This study aims at assessing the occurrence of medical emergencies in a cohort of Italian dentists, to ascertain their level of confidence in the management of these conditions, also based on their educational training and type of medical graduation, and, finally, to know their educational needs, in order to plan appropriate institutional interventions for specific training. MethodsA national-based cross-sectional study was carried out by means of an online survey sent to all dentists working in Italy. ResultsThe survey included 6818 questionnaires. Most of the respondents (n = 4443; 65.2%) reported the occurrence of at least one medical emergency during their professional life. The events rarely resulted in death as declared by only 62 (0.9%) of respondents. The commonest medical emergency was the vasovagal syndrome. Most medical emergencies occurred during the dental procedure (n = 4883; 71.6%). An average degree of satisfaction about the ability to diagnose and manage medical emergencies was reported by most of respondents, with high level of confidence in treating vasovagal syndrome, while a lack in preparedness about the management of myocardial infarction or transient ischemic attack (TIA) and stroke. Medical doctors were more confident in managing the emergencies than dentistry graduates (p < .01). Considering the educational needs, almost all of participants (n = 6721; 98.6%) declared the need to improve their training and expressed their interest in theoretical-practical institutional courses as well as in the establishment of an official national register for medical emergencies occurred in dental practice. ConclusionsMedical emergencies are not negligible and the dentist should receive adequate training and continuing education to be updated and ready for their correct management. Clinical significanceThe dentist should be ready to deal with medical emergencies and provide first aid to the patient. The dentist is not always prepared to manage the most complex emergencies; therefore, there is the need to organize post-graduate courses and to set up an emergency register.

Development of an Untargeted Metabolomics Strategy to Study the Metabolic Rewiring of Dendritic Cells upon Lipopolysaccharide Activation.

Dendritic cells (DCs) are essential immune cells for defense against external pathogens. Upon activation, DCs undergo profound metabolic alterations whose precise nature remains poorly studied at a large scale and is thus far from being fully understood. The goal of the present work was to develop a reliable and accurate untargeted metabolomics workflow to get a deeper insight into the metabolism of DCs when exposed to an infectious agent (lipopolysaccharide, LPS, was used to mimic bacterial infection). As DCs transition rapidly from a non-adherent to an adherent state upon LPS exposure, one of the leading analytical challenges was to implement a single protocol suitable for getting comparable metabolomic snapshots of those two cellular states. Thus, a thoroughly optimized and robust sample preparation method consisting of a one-pot solvent-assisted method for the simultaneous cell lysis/metabolism quenching and metabolite extraction was first implemented to measure intracellular DC metabolites in an unbiased manner. We also placed special emphasis on metabolome coverage and annotation by using a combination of hydrophilic interaction liquid chromatography and reverse phase columns coupled to high-resolution mass spectrometry in conjunction with an in-house developed spectral database to identify metabolites at a high confidence level. Overall, we were able to characterize up to 171 unique meaningful metabolites in DCs. We then preliminarily compared the metabolic profiles of DCs derived from monocytes of 12 healthy donors upon in vitro LPS activation in a time-course experiment. Interestingly, the resulting data revealed differential and time-dependent activation of some particular metabolic pathways, the most impacted being nucleotides, nucleotide sugars, polyamines pathways, the TCA cycle, and to a lesser extent, the arginine pathway.

FaxMatch: Multi-Curriculum Pseudo-Labeling for semi-supervised medical image classification.

Semi-supervised learning (SSL) can effectively use information from unlabeled data to improve model performance, which has great significance in medical imaging tasks. Pseudo-labeling is a classical SSL method that uses a model to predict unlabeled samples and selects the prediction with the highest confidence level as the pseudo-labels and then uses the generated pseudo-labels to train the model. Most of the current pseudo-label-based SSL algorithms use predefined fixed thresholds for all classes to select unlabeled data. However, data imbalance is a common problem in medical image tasks, where the use of fixed threshold to generate pseudo-labels ignores different classes of learning status and learning difficulties. The aim of this study is to develop an algorithm to solve this problem. In this work, we propose Multi-Curriculum Pseudo-Labeling (MCPL), which evaluates the learning status of the model for each class at each epoch and automatically adjusts the thresholds for each class. We apply MCPL to FixMatch and propose a new SSL framework for medical image classification, which we call the improved algorithm FaxMatch. To mitigate the impact of incorrect pseudo-labels on the model, we use label smoothing (LS) strategy to generate soft labels (SL) for pseudo-labels. We have conducted extensive experiments to evaluate our method on two public benchmark medical image classification datasets: the ISIC 2018 skin lesion analysis and COVID-CT datasets. Experimental results show that our method outperforms fully supervised baseline, which uses only labeled data to train the model. Moreover, our method also outperforms other state-of-the-art methods. We propose MCPL and construct a semi-supervised medical image classification framework to reduce the reliance of the model on a large number of labeled images and reduce the manual workload of labeling medical image data.

Nanopublication-based semantic publishing and reviewing: a field study with formalization papers.

With the rapidly increasing amount of scientific literature, it is getting continuously more difficult for researchers in different disciplines to keep up-to-date with the recent findings in their field of study. Processing scientific articles in an automated fashion has been proposed as a solution to this problem, but the accuracy of such processing remains very poor for extraction tasks beyond the most basic ones (like locating and identifying entities and simple classification based on predefined categories). Few approaches have tried to change how we publish scientific results in the first place, such as by making articles machine-interpretable by expressing them with formal semantics from the start. In the work presented here, we propose a first step in this direction by setting out to demonstrate that we can formally publish high-level scientific claims in formal logic, and publish the results in a special issue of an existing journal. We use the concept and technology of nanopublications for this endeavor, and represent not just the submissions and final papers in this RDF-based format, but also the whole process in between, including reviews, responses, and decisions. We do this by performing a field study with what we call formalization papers, which contribute a novel formalization of a previously published claim. We received 15 submissions from 18 authors, who then went through the whole publication process leading to the publication of their contributions in the special issue. Our evaluation shows the technical and practical feasibility of our approach. The participating authors mostly showed high levels of interest and confidence, and mostly experienced the process as not very difficult, despite the technical nature of the current user interfaces. We believe that these results indicate that it is possible to publish scientific results from different fields with machine-interpretable semantics from the start, which in turn opens countless possibilities to radically improve in the future the effectiveness and efficiency of the scientific endeavor as a whole.